After seeing her rural Minnesota community struggle with a growing heroin and opioid addiction problem, Assistant Professor Laura Palombi set out to do something about it.

Palombi – working alongside a grassroots, drug abuse-focused task force – sought to hold a forum that would bring together members of the Cloquet, Minn. community to find a solution.

Palombi and a fellow task force member ultimately secured a grant from the University’s Clinical and Translational Science Institute (CTSI) to support a community forum on heroin and opioid abuse, which successfully rallied the northern Minnesota town.

“The forum mobilized locals and enabled us to secure additional funding so we can replicate best practices in other rural communities hit hard by substance abuse,” said Palombi. “We’d never be where we are now, had it not been for that initial CTSI support.”

Addressing a community needThe idea to hold a community forum sprang from the task force, which unites a wide range of Cloquet community members, including local authorities, police officers, public health officials, medical professionals, tribal leaders, and concerned citizens.

Together, they sought to combat an issue that has personally affected many in their tight-knit town of approximately 12,000. Centers for Disease Control and Prevention data shows that opioid overdose deaths in Minnesota increased by more than 500% between 1999 and 2014. Carlton County – where Cloquet is located – is hit particularly hard, with one of Minnesota’s highest rates of death from opioid overdose.

Not surprisingly, Carlton County residents identified substance abuse and mental health as the county’s top two issues in a recent public health assessment.

Ricky DeFoe addresses a packed room at Cloquet's Community Forum on Heroin and Opioid Abuse, sharing his experience in losing a daughter to a heroin overdose. Also pictured are co-panelists and Carlton County Drug Abuse Task Force members Richard Colsen, Director of Tagwii Recovery Center on the Fond du Lac Reservation, and Paul Couglin, Jail Administrator for Carlton County.

Bringing people togetherAt the inaugural Carlton County Community Forum on Heroin and Opioid Abuse held in October 2015, the task force anticipated about 50 attendees based on similar events, and planned for 100. To their amazement, the forum attracted more than 260 people, with attendance from local communities and the nearby Fond du Lac Indian Reservation.

Attendees heard from a diverse group of panelists about a wide range of topics. For example, a treatment specialist explained how to help a loved one who struggles with addiction, a toxicologist described heroin and opioids’ impact from a medical perspective, and a respected tribal member shared his personal story of alcohol addiction and losing a child to a heroin overdose.

In addition, a question-and-answer session and time for socializing over food sparked a two-way dialogue, and acted as a sounding board. The task force invited attendees to join their team, helping the task force increase awareness and membership over the course of a couple hours.

“The forum marked a big first step in coming together as a community to address opioid and heroin abuse, a life-and-death issue that has affected so many of us,” says Amy LaRue, a public health educator with Carlton County Public Health & Human Services who serves as one of the task force’s leaders and would go on to co-present with Palombi at conferences. “It’s amazing what this one event did, in terms of connecting a diverse group, sparking conversations about the issues, and mobilizing citizens to help make a difference.”

Searching for solutionsWith a successful and well-publicized forum under their belt, the task force relied on feedback collected at the event and via a follow-up survey to guide their next steps.

For example, the survey revealed a clear desire for educational activities, so the group ramped up efforts to educate the community via a second forum, newspapers articles, and monthly educational sessions. At the monthly sessions, different speakers talked about issues related to addiction, such as behavioral health care strategies, helping loved ones seek treatment, and the role of shame in substance abuse.

“I believe we can make a difference through community-based action research, in which researchers work directly with the community to understand what they need and find a solution,” said Palombi, pointing out that community engagement is part of the University’s mission as a land-grant university. “Substance abuse touches virtually everyone in our town, and it’s not going away unless everyone works together.”

Fortunately, the overwhelmingly positive community response and ongoing interest led other University units to provide additional support to sustain and expand activities, including a second forum in Cloquet and an inaugural forum in nearby Moose Lake.

Spreading best practicesAdditional forums and educational programming will enable the task force to continue developing strategies that can be shared beyond the Cloquet area.

“The process for engaging a community and finding solutions would differ between Cloquet and Minneapolis, and even between Cloquet and another rural town,” says Dr. Palombi. “But we do believe there are best practices for rural communities that can be adapted nationwide, which we are working to identify and share broadly.”

Palombi and collaborators have already begun disseminating their findings by publishing an article in the Journal of Rural Health and presenting at several conferences.

In doing so, they’ve drummed up substantial interest from communities, public health groups, and pharmacists across the state who are interested in adapting Palombi and team’s approach for their own communities. Palombi is now exploring ways to engage with fellow pharmacists and give them the tools they need to be successful.

“People don’t often picture pharmacists doing this kind of work out in the community, but it’s absolutely something they’re capable of doing,” said Palombi. “We’re trying to find ways to support pharmacists who want to get out in their communities, and actively contribute to teams that are working to find solutions to substance abuse.”